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SWI and T2*-GRE Microhemorrhage Counts in Anti-Amyloid Therapy Eligibility: A Real-World-Calibrated Simulation Study

INTRODUCTION: Anti-amyloid therapy eligibility excludes patients with five or more cerebral microhemorrhages (CMHs), but current guidance allows either T2*-GRE or the more sensitive SWI. This may create sequence-dependent differences in eligibility classification. METHODS: We fitted a Bayesian right-censored zero-inflated Poisson model to single-center real-world SWI-based CMH counts from 130 memory clinic patients. We then simulated T2*-GRE counts under a directional binomial detection model across a range of relative detection probabilities and estimated two metrics: P(T2*